Q值引导和标准LASIK对视觉质量影响的比较研究  

Comparative research of Q-value guided LASIK and standard LASIK on visual quality

作　　者：李婧[1] 沈政伟[1] 叶娅[1] 

机构地区：[1]广州军区武汉总医院眼科,湖北省武汉市430070

出　　处：《眼科新进展》2012年第1期52-55,共4页Recent Advances in Ophthalmology

摘　　要：目的比较Q值引导的个性化切削(fine adjusted-customized ablation treatment,F-CAT)与标准模式准分子激光原位角膜磨镶术(standard laser in situ keratomileusi,S-LASIK)矫正近视术后的对比度视力、角膜Q值和波前像差,评价其术后视觉质量。方法选取拟在我院行准分子激光近视矫正术的近视患者48例(48眼),分为2组,一组行F-CAT,另一组行S-LASIK,观察并比较术前及术后1个月和3个月的视力、角膜Q值、高阶像差,以及在暗环境下亮、暗两种背景时对比度为100%、25%、10%、5%的视力变化。结果术后1个月、3个月,2组间的裸眼视力差异均无统计学意义(均为P>0.05);角膜Q值均由术前的负值转变为正值,F-CAT组术后角膜Q值小于S-LASIK组,差异均有统计学意义(均为P<0.05);术后3个月,F-CAT组垂直彗差值比术前减少了75.00%,球差、第4阶像差、总高阶像差值均分别增加2.48倍、2.00倍、1.50倍,术前、术后差异均有统计学意义(均为P<0.05);S-LASIK组垂直彗差减少了52.30%,球差、第4阶像差、总高阶像差值均分别增加3.36倍、3.20倍、2.13倍,术前、术后差异均有统计学意义(均为P<0.05);术后1个月、3个月2组间垂直彗差、球差、第4阶像差、总高阶像差的差异均有统计学意义(均为P<0.05)。暗环境暗背景下,F-CAT组术后3个月5%对比度视力(0.47±0.11)优于S-LASIK组(0.55±0.10),差异有统计学意义(P<0.05);暗环境亮背景下,术后F-CAT组对比度视力均优于S-LASIK组。结论在准分子激光矫正近视中,F-CAT术后视觉质量优于S-LASIK,在低光照度和夜间环境下,F-CAT更显其优势。Objective To compare the contrast visual acuity（CVA）,Q-value,wavefront aberration after fine adjusted-customized ablation treatment（F-CAT） LASIK and standard-LASIK（S-LASIK） for myopia,and analyze their visual quality.Methods Forty-eight patients（48 eyes） with myopia were enrolled and divided into two groups,one received F-CAT,and the other performed S-LASIK.The visual acuity,Q-value,high order aberration refraction and CVA at four contrast levels（100%,25%,10%,5%）with bright or dark background in dark environment before and 1 month,3 months after surgery were compared and analyzed.Results At 1 month,3 months after surgery,the difference of uncorrected visual acuity was not statistically significant between two groups（all P0.05）;The Q-values all increased,but which of F-CAT group was less than S-LASIK group,the differences were statistically significant（all P0.05）.At 3 months after surgery,the vertical coma in F-CAT group and S-LASIK group was 75.00%,52.30% less than before surgery,spherical aberration,the 4th order aberration and higher-order aberration was 2.48 times,2.00 times,1.50 times and 3.36 times,3.20 times,2.13 times than before surgery,respectively,the differences between before and after surgery were statistically significant（all P0.05）,which at 1 month and 3 months after surgery between two groups were statistically significant（all P0.05）.At 3 months after surgery,the CVA of 5% contrast degree in F-CAT group（0.47±0.11） was better than that in S-LASIK group（0.55±0.10） at dark background in dark environment,the difference was statistically significant（P0.05）,while all of CVA at illumination background in F-CAT group were better than that in S-LASIK group.Conclusion In all surgeries for myopia,F-CAT shows the better visual quality after surgery than S-LASIK,especially at low illumination or night.

关 键 词：准分子激光原位角膜磨镶术 Q值 波前像差 对比度视力 

分 类 号：R779.6[医药卫生—眼科]